Individual
MS. DENISE R LECLAIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.L.P.
Contact information
Practice address
234 1/2 WASHINGTON AVE, GRAND HAVEN, MI 49417-1375
(616) 607-4476
Mailing address
707 SHELDON RD, GRAND HAVEN, MI 49417-1860
(616) 801-3792
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301008788
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CV0012326
—
MI
Enumeration date
03/25/2019
Last updated
03/25/2019
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